Provider Demographics
NPI:1891596680
Name:ALI ELMI, MOHAMED
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:ALI ELMI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 SW CEDAR HILLS BLVD #2201
Mailing Address - Street 2:N/A
Mailing Address - City:BEAVERTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-9571
Mailing Address - Country:US
Mailing Address - Phone:206-790-6791
Mailing Address - Fax:
Practice Address - Street 1:2850 SW CEDAR HILLS BLVD #2201
Practice Address - Street 2:N/A
Practice Address - City:BEAVERTON
Practice Address - State:MN
Practice Address - Zip Code:55024-9571
Practice Address - Country:US
Practice Address - Phone:206-790-6791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide